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Year

(Name of Insurer)

Annual Return

P&C - 1

Canadian
Property and Casualty Insurers

Jurisdiction of incorporation:

Uniform Annual Return approved by the Canadian Council of Insurance Regulators

(2012)
Insurer Year

ANNUAL RETURN
P&C-1
TABLE OF CONTENTS
Page
General Information
Corporate Data, Officers, Auditor, Actuary 10.10
Directors 10.15
Annual Corporate Information (Quebec*) 10.16
Annual Corporate Information (All provinces) 10.17
Shares 10.20
Shareholders 10.20
Corporate Organization Chart 10.30
Other Information 10.40-.42
Summary of Selected Financial Data for five years 10.60

CONSOLIDATED FINANCIAL STATEMENTS AND EXHIBITS

Financial Statements
Assets 20.10
Liabilities and Equity 20.20
Statement of Income 20.30
Statement of Retained Earnings 20.40
Reserves 20.40
Comprehensive Income(Loss) & Accumulated Other Comprehensive Income(Loss) 20.42
Statement of Cash Flows 20.52
Statement of Changes in Equity 20.54
Notes to Financial Statements 20.60
Auditor's Report 20.70
Appointed Actuary's Report 20.80

Statutory Compliance
Minimum Capital Test 30.70
Capital Required for Balance Sheet Assets 30.71
Capital Required for Balance Sheet Assets based on External Credit Ratings 30.73

Investments
Summary of Investments 40.07
Short Term Investments 40.12
Bonds and Debentures 40.22
Mortgage Loans 40.32
Preferred Shares 40.42
Common Shares 40.52
Investment Properties 40.70
Other Loans and Invested Assets 40.80

Miscellaneous Assets and Liabilities


Receivable from/payable to Non-Associated Agents & Brokers 50.20
Other Receivables 50.20
Receivable from/payable to Other Insurers 50.30
Interest in & Amounts receivable from/payable to
Associates & Joint Ventures 50.40
Other Assets and Liabilities, and Unrecognized Assets and Liabilities 50.50

Premiums, Claims and Adjustment Expenses


Unearned Premiums 60.10
Premiums and Claims 60.20
Claims Incurred - Undiscounted 60.21
Claims and Adjustment Expenses - Paid, Current Year and Unpaid, Current and
Prior Year 60.30
Net Claims and Adjustment Expenses Run-off 60.40
Net Claims and Adjustment Expenses Run-off - Discounted 60.41
Adjustment Expenses 60.50

* To be filed by all insurers licensed in Quebec Page 2 P&C-1 (2012)


Insurer Year

ANNUAL RETURN
P&C-1
TABLE OF CONTENTS
Page

Provincial and Territorial Summaries


Premiums Written 67.10
Premiums Earned 67.20
Claims Incurred 67.30
Claims Incurred - Undiscounted 67.31

Reinsurance Ceded
Premiums and Claims - Reinsurance Ceded 70.10
Summary of Reinsurance 70.21
Unregistered Insurers 70.38
Reinsurance and Other Non-owned Assets Held on Deposit and Letters of Credit 70.40

Commissions and Expenses


Commissions 80.10
Expenses - Insurance Operations 80.20

Out of Canada Exhibits


Out of Canada Operations 90.15
Reinsurance Ceded 90.70

NON-CONSOLIDATED FINANCIAL STATEMENTS AND EXHIBITS

Financial Statements
Assets 92.10
Liabilities and Equity 92.20
Statement of Income 92.30
Statement of Retained Earnings 92.40
Reserves 92.40
Comprehensive Income(Loss) & Accumulated Other Comprehensive Income(Loss) 92.42

Premiums, Claims and Adjustment Expenses


Premiums and Claims 93.10
Claims Incurred - Undiscounted 93.11
Claims and Adjustment Expenses - Paid, Current Year and Unpaid, Current and Prior Year 93.20
Provincial & Territorial Summaries - Premiums Written 93.30
Premiums Written (Policies with a term of more than 12 months) (Quebec*) 93.35
Provincial & Territorial Summaries - Premiums Earned 93.40
Provincial & Territorial Summaries - Claims Incurred 93.50
Net Claims and Adjustment Expenses Run-off 93.60
Net Claims and Adjustment Expenses Run-off - Discounted 93.61

Miscellaneous
Premiums and Claims - Reinsurance Ceded (Quebec*) 95.10
Commissions (Quebec*) 95.20

Affidavit Verifying Annual Return 99.10

* To be filed by all insurers licensed in Quebec Page 3 P&C-1 (2012)


10.10

Insurer Year
ANNUAL RETURN
for the year ended

01 ____________________

02 Insurer
03 Head Office Address
04 -
05 Mailing Address
06 (if different) -
07 Telephone ( )
08 Fax ( )
09 Website
20 Contact
21 Title
22 Telephone ( )
23 Fax ( )
24 Email Address

(date of filing return)


30 Officers as at (date of filing return)
36 President/Chief Executive Officer
37 Citizenship
38 Address
39 -

41 Chief Financial Officer


42 Citizenship
43 Address
44 -

51 Secretary
52 Citizenship
53 Address
54 -

61 External Auditor*
62 Partner
63 Address
64 -
65 Telephone ( )
66 Fax ( )

72 Actuary*
73 Address
74 -
75 Telephone ( )
76 Fax ( )

* An Auditor's Report and an Actuary's Report are required to be filed with the Annual Return.

P&C-1 (2008)
(Next page is 10.15)
10.15

Insurer Year
01 DIRECTORS as at
(Date of filing return)

Chairperson of the Board


10 Name
11 Citizenship
12 Address
13 -

Chairperson of the Audit Committee


15 Name
16 Citizenship
17 Address
18 -

Chairperson of the Conduct Review Committee


20 Name
21 Citizenship
22 Address
23 -
25 Name
26 Citizenship
27 Address
28 -
30 Name
31 Citizenship
32 Address
33 -
35 Name
36 Citizenship
37 Address
38 -
40 Name
41 Citizenship
42 Address
43 -
45 Name
46 Citizenship
47 Address
48 -
50 Name
51 Citizenship
52 Address
53 -
55 Name
56 Citizenship
57 Address
58 -
60 Name
61 Citizenship
62 Address
63 -
64 Name
65 Citizenship
66 Address
67 -

P&C-1 (2003)
(Next page is 10.16)
10.16

Insurer Year
ANNUAL CORPORATE INFORMATION

For insurers licensed in the province of Quebec

RETURN FOR THE YEAR ENDED:


01
(Day, Month, Year)

Chief Representative in Quebec (if Head Office is not in Quebec):


02 Name of Chief Agent
03 Mailing Address
04 -
05 Telephone ( )
06 Fax ( )
07 E-mail

If changes have occurred regarding the chief representative in Quebec and the public information
appearing on the Website of the Autorité des marchés financiers (the "AMF") (www.lautorite.qc.ca)
is not accurate, the insurer must complete and attach the "Quebec Power of Attorney for
designation of a chief representative in Quebec" form, as required under the Act (s. 207 and 208),
available at:
http://www.lautorite.qc.ca/files/pdf/formulaires-professionnels/assureur/form-procurationrepr-princ-en.pdf

(date of filing return)

Order to commence and carry on business issued by OSFI or by the province of constitution
(for an insurer not incorporated under an Act of Québec):

Please attach a copy of the most recent Order issued by OSFI or by the province of constitution
indicating the authorized classes of insurance.

P&C-1 (2012)
(Next page is 10.17)
10.17

Insurer Year
ANNUAL CORPORATE INFORMATION

* PROVINCIAL PAGE

RETURN FOR THE YEAR ENDED:


01
(Day, Month, Year)

List of different committees and of their members:

Please attach the most recent list of the various committees and their members (*) and identify the person
acting as President (Chair) of each committee.

* For professional orders, please provide information regarding directors and officers of the insurance fund,
not of the professional order.

Committee Members (*) Members (*) Members (*)


02
03
04
05

* Insurers licensed/incorporated in each provincial jurisdiction must file this page.

P&C-1 (2012)
(Next page is 10.20)
10.20

Insurer Year

CONSOLIDATED

SHARES

Authorized Issued
Class and Full Description Number Amount Number Amount Amount
Paid Unpaid
(01) (02) (03) (04) (05) (06)
Common $'000 $'000 $'000

01
02
03
Preferred
04
05
06

SHAREHOLDERS

Name Location Number of % of Voting Amount


(City) Shares Held Rights Paid
(01) (02) (03) (04) (05)
$'000

61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
Total 89 100%

P&C-1 (2011)
(Next page is 10.30)
10.30

Insurer Year

CORPORATE ORGANIZATION CHART *

Complete or attach a chart showing the interrelationships between the insurer, its immediate and ultimate
parent, and all other affiliated corporations (upstream and downstream), identifying the percentage of
beneficial ownership of each (see Section VI of the Annual Return Instructions).

* Insurers must attach their corporate organization chart on this tab.

P&C-1 (2011)
(Next page is 10.40)
10.40

Insurer Year
NON CONSOLIDATED

OTHER INFORMATION

10 Have there been any amendments to the instrument of incorporation/by-laws


since the date of filing the last Annual Return? Y/N
If yes, please summarize:
11
12
13

20 Have there been any substantial changes in ownership since the date of
filing the last Annual Return? Y/N
If yes, give details:
21
22
23

30 Indicate the name and percentage of ownership of each corporation in which the insurer held 10%
or more of the voting rights as at year-end.
If necessary, provide details on an additional page.
Name Percentage Consolidated
31 Y/N

32 Y/N

33 Y/N

37 Y/N

38 Y/N

39 Y/N

35 Is the insurer licensed in, or does the insurer cover risks in any foreign jurisdiction?
Y/N
If yes, please provide details on page 90.15

36 Are any of the insurer's licences/order subject to any limitation? Y/N


If yes, please provide details.

40 Has the insurer contracted for any management services? Y/N


If yes, give details:

(01) (02)
41 Name Type of service

42 Address Affiliated Y/N


43 -
44 Name Type of service

45 Address Affiliated Y/N


46 -
47 Name Type of service

48 Address Affiliated Y/N


49 -

P&C-1 (2011)
(Next page is 10.41)
10.41

Insurer Year
CONSOLIDATED

OTHER INFORMATION (continued)

Total Net retention


Class of insurance Insured Value Policy Limit Current Year Prior Year
(05) (01) (02) (03)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Aircraft 10
Automobile
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70

75 Has the insurer made any significant changes regarding reinsurance arrangements
during the year? Y/N

If yes, attach details (see Section VI of the Annual Return Instructions).

76 Has the insurer made any portfolio transfer, and/or commutation of reinsurance
treaties during the year? Y/N

If yes, attach details (see Section VI of the Annual Return Instructions).

72 What is the upper limit of the catastrophe program? ($'000)

82 What is the attachment point for catastrophe coverage? ($'000)

83 What is the amount of retention (if any) within the catastrophe coverage layers? ($'000)

84 What is the gross estimated catastrophe exposure? ($'000)

86 Based on the gross estimated catastrophe exposure above, what would be the net
retained loss (after all reinsurance)? ($'000)

73 Based on the gross estimated catastrophe exposure above, what would be the catastrophe
coverage(s) reinstatement cost for a full year? ($'000)

87 Is the catastrophe program specific to the Canadian operations only? Y/N

Current Year Prior Year


(02) (03)
What is the average rate used for discounting policyholder liabilities (%)? 90 % %
What is the average duration of interest rate sensitive assets? 91
Number of automobiles insured under automobile insurance policies , as at year-end: 79
Assessable Income information ($'000):
Accident and Sickness net premiums written in Ontario 85

P&C-1 (2012)
(Next page is 10.42)
10.42

Insurer Year

CONSOLIDATED

OTHER INFORMATION (continued)

01 Were any of the assets of the insurer pledged as security or lodged as


collateral as at year-end? Y/N

If yes, give details (see Section VI of the Annual Return Instructions):


02
03
04

20 Does the insurer have any significant dependencies not already disclosed in answer(s)
to previous questions or in the Notes to Financial Statements? Y/N

If yes, give details (see Section VI of the Annual Return Instructions).

21
22
23
24
25

30 Have you or your parent issued insurance-linked securities for


in-Canada risks? Y/N

If Yes, what is the value in ($'000's)?


34 For the Canadian legal entity?
35 For the Parent?

Current Year Prior Year


($'000) ($'000)
(02) (03)
Market value of securities on loan 40
Market value of total collateral of securities on loan 45
Market value of pledged assets 50

P&C-1 (2012)
(Next page is 10.60)
10.60

Insurer Year
CONSOLIDATED

SUMMARY OF SELECTED FINANCIAL DATA FOR FIVE YEARS


($'000)

(Current)
(01) (02) (03) (04) (05)

OPERATIONS
Assets 01
Liabilities 02
Adjusted Equity 04
Gross premiums written 05
Net premiums written 06
Net premiums earned 07
Gross claims incurred 08

PROFITABILITY
Claims ratio
- by year of account 30 % % % % %
- by year of accident 31 % % % % %
Expense ratio 33 % % % % %
Underwriting income (loss) 35
- as a % of net premiums earned 36 % % % % %
Net investment income from insurance operations 40
Net income (loss) from insurance operations
(line 35 + 40) 41
Net investment income - other 44
Net investment income (total) as a % of net
premiums earned [(line 40 + 44)/07] x 100 45 % % % % %
Investment yield 46 % % % % %
Net income (loss) 47
Return on equity 48 % % % % %

FINANCIAL
Dividends to shareholders 50
Share Capital and Contributed Surplus
paid in during the year 52
Share Capital and Contributed Surplus
redeemed during the year 54

OTHER RATIOS
Adjusted Equity as a % of liabilities 60 % % % % %
Gross risk ratio (line 05/line 04) 62
Net risk ratio (line 06/line 04) 64
Agents and brokers balances and amounts
due from subsidiaries and associates as
a % of Adjusted Equity 66 % % % % %
Claims development as a % of Adjusted Equity 68 % % % % %

MINIMUM CAPITAL TEST


Excess of Capital Available over Capital Required 70
Capital Available as a % of Capital Required 72 % % % % %
What is the company's internal target capital ratio (%)? 74 % % % % %

P&C-1 (2012)
(Next page is 20.10)
20.10

Insurer Year

CONSOLIDATED FINANCIAL STATEMENTS

ASSETS
($'000)

FS Current Prior Opening


Page Notes Year Year Prior Year
Restated
Reference (01) (03) (05)

Cash and Cash Equivalents 01


Investment Income due and accrued 02
Assets held for sale 50
Investments:
40.12 Short Term Investments 04
40.22 Bonds and Debentures 05
40.32 Mortgage Loans 06
40.42 Preferred Shares 07
40.52 Common Shares 08
40.70 Investment Properties 09
40.80 Other Loans and Invested Assets 10

40.07 Total Investments (lines 04 to 10) 19

Receivables:
50.20 Unaffiliated Agents and Brokers 20
Policyholders 21
Instalment Premiums 22
50.30 Other Insurers 23
Facility Association and the "P.R.R." 24

50.40 Subsidiaries, Associates & Joint Ventures 25


50.20 Other Receivables 27

Recoverable from Reinsurers:


60.10 Unearned Premiums 30
60.30 Unpaid Claims and Adjustment Expenses 31
Other Recoverables on Unpaid Claims 37

50.40 Interests in Subsidiaries, Associates & Joint Ventures 40


40.70 Property and Equipment 41
Deferred Policy Acquisition Expenses 43
Current Tax Assets 52
Deferred Tax Assets 44
Goodwill 54
Intangible Assets 56
50.50 Other Assets 88
TOTAL ASSETS 89

P&C-1 (2012)
(Next page is 20.20)
20.20

Insurer Year

CONSOLIDATED FINANCIAL STATEMENTS

LIABILITIES AND EQUITY


($'000)

FS Current Prior Opening


Page Notes Year Year Prior Year
Restated
Reference (01) (03) (05)

LIABILITIES
Overdrafts 01
Borrowed Money and Accrued Interest 02
Payables:
50.20 Agents and Brokers 03
Policyholders 04
50.30 Other Insurers 05
50.40 Subsidiaries, Associates & Joint Ventures 06
Expenses due and accrued 07
Other Taxes due and accrued 09
Policyholder Dividends and Rating Adjustments 10
40.70 Encumbrances on Real Estate 11
60.10 Unearned Premiums 12
60.30 Unpaid Claims and Adjustment Expenses 13
80.10 Unearned Commissions 14
Premium Deficiency 15
Liabilities held for sale 17
Current Tax Liabilities 18
Deferred Tax Liabilities 21
50.50 Provisions and Other Liabilities 28

Total Liabilities 29

EQUITY
Shares issued and paid 41
Contributed Surplus 42
(Specify) 43
20.40 Retained Earnings 44
20.40 Reserves 45
20.42 Accumulated Other Comprehensive Income (Loss) 47
Total Policyholders/Shareholders' Equity 59
Non-controlling Interests 48
Total Equity 49
TOTAL LIABILITIES AND EQUITY 89

P&C-1 (2012)
(Next page is 20.30)
20.30

Insurer Year
CONSOLIDATED FINANCIAL STATEMENTS

STATEMENT OF INCOME
($'000)
FS Current Prior
Page Notes Year Year
Reference (01) (03)
UNDERWRITING OPERATIONS
Premiums Written
Direct 01
70.21 Reinsurance Assumed 02
70.21 Reinsurance Ceded 03
60.20 Net Premiums Written 04
Decrease (increase) in Net Unearned Premiums 05
60.20 Net Premiums Earned 06
Service Charges 07
Other 08
Total Underwriting Revenue 09
Gross Claims and Adjustment Expenses 62
Reinsurers' share of claims and adjustment expenses 64
60.20 Net Claims and Adjustment Expenses 10
Acquisition Expenses
80.10 Gross Commissions 66
80.10 Ceded Commissions 68
Taxes 12
80.20 Other 14
80.20 General Expenses 16
Total Claims and Expenses 19
Premium Deficiency Adjustments 20
Underwriting Income (Loss) 29
40.07 INVESTMENT OPERATIONS
Income 32
Realized Gains (Losses) 33
Expenses 34
Net Investment Income 39
OTHER REVENUE AND EXPENSES
Income (Loss) from Ancillary Operations
(net of Expenses of $'000 ...................) 40
Share of Net Income (Loss) of Subsidiaries, Associates
& Joint Ventures 41
Gains (Losses) from fluctuations in Foreign Exchange Rates 42
Other Revenues 44
Finance costs 45
Other Expenses 46
Net Income (Loss) before Income Taxes 49
INCOME TAXES
Current 50
Deferred 51
Total Income Taxes 59
NET INCOME (LOSS) FOR THE YEAR 89
ATTRIBUTABLE TO:
Non-controlling Interests 80
Equity Holders 82
P&C-1 (2012)
(Next page is 20.40)
20.40

Insurer Year

CONSOLIDATED FINANCIAL STATEMENTS

STATEMENT OF RETAINED EARNINGS


($'000)

FS Current Prior
Page Notes Year Year
Reference (01) (02)

Balance at beginning of year 01


Prior period adjustments: 02
(Specify) 04
Adjusted balance at beginning of year 09
20.30 Net income (loss) for the year 10
Dividends declared to shareholders 11
Decrease (increase) in Reserves 12
(Specify) 16
Net increase (decrease) in Retained Earnings
during the year 15
Balance at end of year 89

RESERVES
($000)

FS Current Prior
Page Notes Year Year
Reference (01) (02)
Earthquake Reserves
Reserve Complement 90
Premium Reserve 91
Mortgage Reserve 95
Nuclear Reserve 96
General and Contingency Reserves 98
Total Reserves 99

P&C-1 (2011)
(Next page is 20.42)
20.42

Insurer Year
CONSOLIDATED FINANCIAL STATEMENTS
COMPREHENSIVE INCOME (LOSS)
and
ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS)
($'000)

FS Current Prior
Page Notes Year Year
Reference (01) (03)

Comprehensive Income (Loss)


20.30 Net Income 01
Other Comprehensive Income (Loss):
Available for Sale:
Change in Unrealized Gains and Losses:
- Loans 02
- Bonds and Debentures 03
- Equities 04
Reclassification to Earnings of (Gains) Losses 05
Derivatives Designated as Cash Flow Hedges
Change in Unrealized Gains and Losses 06
Reclassification to Earnings of (Gains) Losses 07
Foreign Currency Translation
Change in Unrealized Gains and Losses 08
Impact of Hedging 09
Revaluation Surplus 31
Share of Other Comprehensive Income of Subsidiaries,
Associates & Joint Ventures 11
Other 12
Total Other Comprehensive Income (Loss) 21
Total Comprehensive Income (Loss) 39
Attributable to:
Non-controlling Interests 60
Equity Holders 62

Current Prior
Year Year
(01) (03)
Accumulated Other Comprehensive Income (Loss)
Accumulated Gains (Losses) on:
Available for Sale:
- Loans 42
- Bonds and Debentures 43
- Equities 44
Derivatives Designated as Cash Flow Hedges 45
Foreign Currency (net of hedging activities) 46
Revaluation Surplus 71
Share of Other Comprehensive Income of Subsidiaries,
Associates & Joint Ventures 51
Other 49
20.20 Balance at end of Year 59

P&C-1 (2012)
(Next page is 20.52)
20.52

Insurer Year
CONSOLIDATED FINANCIAL STATEMENTS
STATEMENT OF CASH FLOWS *
($'000)

* Insurers must attach a Statement of Cash Flows as prepared for the insurer's
financial statements on this tab.

P&C-1 (2011)
(Next page is 20.54)
20.54

Insurer Year

CONSOLIDATED FINANCIAL STATEMENTS

STATEMENT OF CHANGES IN EQUITY


($'000)

Accumulated Other Comprehensive Income (Loss)


Share Other Contributed Retained Reserves Available- Cash Flow Translation Revaluation Share of Other Total Non-controlling Total
Capital Capital Surplus Earnings for-Sale Hedges of Foreign Surplus OCI of AOCI Policyholders/ Interests Equity
Financial Operations Associates Shareholder's
Assets & Joint Equity
Ventures
(01) (13) (21) (03) (23) (07) (09) (05) (11) (25) (31) (15) (17) (19)

Balance at Beginning of Prior Year 01


Total Comprehensive Income for the year 09
Issue of Share Capital 02
Transfer from (to) Retained Earnings 15
Decrease (increase) in Reserves 13
Dividends
Preferred 17
Common 18
Other 16
Balance at End of Prior Year 19

Changes in Equity for Current Year


Total Comprehensive Income for the year 29
Issue of Share Capital 22
Transfer from (to) Retained Earnings 35
Decrease (increase) in Reserves 33
Dividends
Preferred 37
Common 38
Other 36
Balance at End of Current Year 39

P&C-1 (2012)
(Next page is 20.60)
20.60

Insurer Year
CONSOLIDATED

NOTES TO FINANCIAL STATEMENTS *

See Section VI of the Annual Return Instructions

* Insurers must attach their notes to the financial statements on this tab.

P&C-1 (2011)
(Next page is 20.70)
20.70

Insurer Year

CONSOLIDATED

AUDITOR REPORTS *

* Federally regulated insurers must file their Auditor Reports as separate documents as
defined in the Automated Data Transfer (ADT) User Guide.

** All other insurers must attach the Auditor's Report on this tab.

P&C-1 (2012)
Next Page is 20.70
20.80

Insurer Year

CONSOLIDATED

APPOINTED ACTUARY'S REPORT *

For the exact wording for the Expression of Opinion, please refer to the
Memorandum to the Appointed Actuary (P&C Insurance).

* Federally regulated insurers are required to file the Appointed Actuary's Report as a separate
document as defined in the Automated Data Transfer (ADT) User Guide.

** All other insurers must attach the Appointed Actuary's Report on this tab.

P&C-1 (2012)
Next Page is 30.70
30.70

Insurer Year

CONSOLIDATED

MINIMUM CAPITAL TEST


($'000)

Current Prior
Year Year
(01) (02)
Capital Available
Total Equity less Accumulated Other Comprehensive Income 02
Add:
Subordinated Indebtedness and Redeemable Preferred Shares 03
Accumulated Other Comprehensive Income (Loss) on:
Available for Sale Equity Securities 04
Available for Sale Debt Securities 06
Foreign Currency (Net of Hedging Activities) 08
Share of Other Comprehensive Income of non-qualifying Subsidiaries,
Associates & Joint Ventures 36
Revaluation Losses in Excess of Gains on Own Use Properties 32
(Specify) 30
Less:
Accumulated net after-tax fair value gains (losses) arising from
changes in the company's own credit risk 12
Unrealized Fair Value Gains (Losses) from Own Use
Properties at Conversion 15
Shadow Accounting Impact 16
Assets with a Capital Requirement of 100% 17
(Specify) 13
IFRS Conversion Phase in 18
Total Capital Available 19

Minimum Capital Required


Balance Sheet Assets 20
Unearned Premiums/Unpaid Claims/Premium Deficiencies 22
Catastrophes 24
Reinsurance Ceded to Unregistered Insurers 26
Interest Rate Risk 38
Foreign Exchange Risk (for future use only) 40
Structured Settlements, Letters of Credit, Derivatives and
Other Exposures 28
(Specify) 34
Minimum Capital Required 29
Excess Capital Available over Minimum Capital Required
(line 19 minus line 29) 89
Line 19 as a % of line 29 90

Minimum Gross Capital Level 96

Note: See Section VI of the P&C-1 instructions and the MCT Guideline. P&C-1 (2012)
(Next page is 30.71)
30.71

Insurer Year
CONSOLIDATED
MINIMUM CAPITAL TEST
CAPITAL REQUIRED FOR BALANCE SHEET ASSETS
($'000)
Factor Balance Capital
Sheet Required
(%) Value
(01) (02) (03)
Cash 01 0.00%
Investment Income Due and Accrued 02 2.00%
Investments:
Term Deposits, Bonds and Debentures 06
Commercial Paper 07
Loans (at amortized cost):
Government Grade 13 0.00%
Loans rated A- and higher, and Residential Mortgages 14 4.00%
Commercial Mortgages 15 8.00%
Other 18 10.00%
Subsidiaries, Associates & Joint Ventures (not considered capital) 23 35.00%
Adjustment to reflect difference between amortized cost
and Balance Sheet value of loans 19
Preferred Shares 25
Common Shares 27 15.00%
Investment Properties 30 15.00%
Interests in Subsidiaries, Associates & Joint Ventures 34 Note
Other Investments 35 Note
Receivables:
Government Grade 50 0.00%
Facility Association and the "P.R.R." 51 0.50%
Agents, Brokers, Policyholders, Associates,
Joint Ventures, Non-qualifying Subsidiaries and Other Receivables:
- Instalment Premiums (not yet due) 54 0.00%
- Outstanding less than 60 days 55 4.00%
- Outstanding 60 days or more 56 8.00%
Insurers - Registered Associated 42 0.00%
- Registered Non-associated 57 0.50%
- Unregistered 58
Recoverable from Reinsurers:
- Registered Associated - Unearned Premiums 45 0.00%
- Unpaid Claims 46 0.00%
- Registered Non-associated - Unearned Premiums 60 0.50%
- Unpaid Claims 61 2.00%
- Unregistered 63
Other Recoverables on Unpaid Claims including SIRs not deducted from capital 65 15.00%
Own Use Properties (valued using cost model) 75 8.00%
Adjustment to reflect difference between cost model
and Balance Sheet value of Own use Properties 70
Deferred Policy Acquisition Expenses:
Premium Taxes 76 0.00%
Commissions 77 Note
Other 78 Note
Deferred Tax Assets:
Discounted Reserves and Unrealized Gains 80 0.00%
Other 81 Note
Other Assets:
Goodwill and Other Intangibles 85 Note
Computer Software 84 35.00%
Other Assets (net of Goodwill, Other Intangibles and Computer Software) 86 Note
(Specify) 88 Note
TOTAL 89

Note: See Section VI of the P&C-1 instructions and the MCT Guideline. P&C-1 (2012)
(Next page is 30.73)
30.73
(Date)
Insurer

CONSOLIDATED

CAPITAL REQUIRED FOR BALANCE SHEET ASSETS BASED ON EXTERNAL CREDIT RATINGS
($000)

Term Deposits, Bonds and Debentures


Term to Maturity
Greater than 1 year Greater than
up to and including
1 year or less 5 years 5 years
Rating Balance Sheet Capital Balance Sheet Capital Balance Sheet Capital Capital Required
Value Factor Value Factor Value Factor Col.(01x02)+(03x04)+(05x06)
(01) (02) (03) (04) (05) (06) (09)
Government Grade 01 0.00% 0.00% 0.00%
AAA 02 0.25% 0.50% 1.25%
AA+ to AA- 03 0.25% 1.00% 1.75%
A+ to A- 04 0.75% 1.75% 3.00%
BBB+ to BBB- 05 1.50% 3.75% 4.75%
BB+ to BB- 06 3.75% 7.75% 8.00%
B+ to B- 07 7.50% 10.50% 10.50%
Other 08 15.50% 18.00% 18.00%
Total 09

Commercial Paper
Balance Sheet Capital Capital Required
Rating Value Factor Col.(01x02)
(01) (02) (09)
A-1, F1, P-1, R-1 or equivalent 20 0.25%
A-2, F2, P-2, R-2 or equivalent 21 0.50%
A-3, F3, P-3, R-3 or equivalent 22 2.00%
All other ratings, including non-prime and B or C ratings 23 8.00%
Total 29

Preferred Shares
Balance Sheet Capital Capital Required
Rating Value Factor Col.(01x02)
(01) (02) (09)
AAA, AA+ to AA-, Pfd-1, P-1 or equivalent 40 3.00%
A+ to A-, Pfd-2, P-2 or equivalent 41 5.00%
BBB+ to BBB-, Pfd-3, P-3 or equivalent 42 10.00%
BB+ to BB-, Pfd-4, P-4 or equivalent 43 20.00%
B+ or lower, Pfd-5, P-5 or equivalent or unrated 44 30.00%
Total 49

Note: See Section VI of the P&C-1 instructions and the MCT Guideline.

P&C-1 (2012)
(Next page is 40.07)
40.07

Insurer Year
CONSOLIDATED
SUMMARY OF INVESTMENTS
($'000)

Fair Value Amortized Balance Realized Income Gain/(Loss)


Held Available Hedges FV Option/ Cost Sheet Gains(Losses) excluding From
for for Investment (01+03+05+ gains/losses on FV Option
Trading Sale Properties 07+09) FV Option
Fair Value
(01) (03) (05) (07) (09) (12) (15) (16) (19)
Aggregate Holdings:
Short Term Investments, Bonds and Debentures (1 year or less) 01
Bonds and Debentures > 1 year and ≤ 5 years 02
Bonds and Debentures > 5 years 05
Mortgage Loans - ≤ 80% Loan to Value Ratio 03
- Other 04
Preferred Shares - Debt 10
- Equity 11
Common Shares 15
Investment Properties 20
Other Loans and Invested Assets 30
Total Investments 39

Out of Canada 40
Foreign Pay Securities 41

Individual Holdings:
Largest Exposure to an Entity or Connected Group 50
2nd Largest Exposure to an Entity or Connected Group 51
Largest Pooled Holding 60
2nd Largest Pooled Holding 61

P&C-1 (2012)
(Next page is 40.12)
40.12

Insurer Year
CONSOLIDATED
SHORT TERM INVESTMENTS
($ 000)

Interest Fair Value Balance


Date of Date of Amortized Sheet Value
Rate Par Value Held for Available Fair Value
Where/By whom kept Description Due dates Issue Maturity Hedges Cost (10+12+14+
% Trading for Sale Option 16+18)
(01) (02) (03) (04) (05) (06) (07) (10) (12) (14) (16) (18) (29)
Total Short Term Investments Government - Federal 09
Total Short Term Investments Government - Provincial 19
Total Short Term Investments Government - Municipal, Public Authority, School 29

Total Short Term Investments Foreign Government 35

Total Short Term Investments - Rating of A 1, R 1 40

Total Short Term Investments - Rating of A 2, R 2 45

Total Short Term Investments - Rating of A 3, R 3 49

Total Short Term Investments - Rating of B, R 4 60

Total Short Term Investments - Rating of B 1, R 5 65

Total Short Term Investments - Rating of B 2, D 69

Total Short Term Investments - Other 89


Total Short Term Investments 99

P&C-1 (2012)
(Next page is 40.22)
40.22

Insurer Year
CONSOLIDATED
BONDS AND DEBENTURES
($ 000)

Interest Fair Value Balance


Rate Due Date of Date of Par Value Held for Available Hedges Fair Value Amortized Sheet Value
Where/By whom kept Description Rating % Dates Issue Maturity Trading for Sale Option Cost (10+12+14
+16+18)
(01) (02) (03) (04) (05) (06) (07) (08) (10) (12) (14) (16) (18) (29)
Total Bonds Government - Federal 09
Total Bonds Government - Provincial 19
Total Bonds Government - Municipal, Public Authority, School 29

Total Bonds Foreign Government 35

Total Bonds rated A- or higher - Expiring or redeeming in one year or less 39

Total Bonds rated A- or higher - > 1 year and ≤ 5 years 49

Total Bonds rated A- or higher - > 5 years 59

Total Bonds rated BBB+ and lower - Expiring or redeeming in one year or less 69

Total Bonds rated BBB+ and lower - > 1 year and ≤ 5 years 79

Total Bonds rated BBB+ and lower - > 5 years 89


Total Bonds and Debentures 99

P&C-1 (2012)
(Next page is 40.32)
40.32

Insurer Year
CONSOLIDATED
MORTGAGE LOANS
($ 000)

Current Balance
Where/By whom kept Description Identification Date of Issue Interest Rate Original Original Value Market Value Sheet
Number Loan Amount of Property of Property Value
(01) (02) (03) (04) (05) (06) (07) (08) (09)

Total Government Grade Guarantor Mortgage Loans 29

Total Residential Mortgages 39

Total Commercial Mortgage Loans 49

Total Other Mortgages 59


Total Mortgage Loans 89

P&C-1 (2012)
(Next page is 40.42)
40.42

Insurer Year
CONSOLIDATED

PREFERRED SHARES
($ 000)
Fair Value Balance
Where/ Number Held for Available Hedges Fair Value Amortized Sheet Value Original
By whom kept Description of Shares Trading for Sale Option Cost (10+12+14 Cost
+16+18)
(01) (02) (03) (10) (12) (14) (16) (18) (29) (39)

Total AAA, AA, Pfd-1, P-1 29

Total A, Pfd-2, P-2 39

Total BBB, Pfd-3, P-3 49

Total BB, Pfd-4, P-4 59

Total B, Pfd-5, P-5 or unrated 79


Total Preferred Shares 89

P&C-1 (2012)
(Next page is 40.52)
40.52

Insurer Year
CONSOLIDATED

COMMON SHARES
($ 000)
Fair Value
Where / Number of Held for Available Hedges Fair Value Balance Original
By whom kept Description Shares Trading for Sale Option Sheet Value Cost
(10+12+14+16)
(01) (02) (03) (10) (12) (14) (16) (29) (39)

Total common shares 89

P&C-1 (2011)
(Next page is 40.70)
40.70

Insurer Year
CONSOLIDATED

INVESTMENT PROPERTIES
($'000)

Year Amount of Value Using Balance Sheet


Description of Property Aquired Encumbrances Cost Model Market Value Value

(01) (02) (03) (04) (05) (06)


Investment Properties

Total Investment Properties 49


For Own Use

Total Own Use Properties 79

Equipment 80

Property and Equipment 69

P&C-1 (2012)
(Next page is 40.80)
40.80

Insurer Year

CONSOLIDATED

OTHER LOANS AND INVESTED ASSETS


($'000)

Where/By whom kept Description Fair Value Balance


Sheet
Value
(01) (02) (03) (04)

Total 89

Basket clause items 99

P&C-1 (2012)
(Next page is 50.20)
50.20

Insurer Year
CONSOLIDATED

RECEIVABLE FROM/PAYABLE TO NON-ASSOCIATED AGENTS AND BROKERS


($'000)
Receivable Payable
Name of Agent or Broker In Arrears Total Total

(01) (02) (03) (04)


See Section VI of the Annual Return Instructions

All Others
Sub-Total 39
Less: Allowance for Doubtful Accounts 40
Total 49
Number of Agents and Brokers 59

OTHER RECEIVABLES
($'000)

Description

(02)
See Section VI of the Annual Return Instructions

All Others

Total 89

P&C-1 (2011)
(Next page is 50.30)
50.30

Insurer Year

CONSOLIDATED

RECEIVABLE FROM/PAYABLE TO OTHER INSURERS


($'000)

Receivable Payable
Name of Insurer In Arrears Total Total
(01) (02) (03) (04)
Registered

Total Registered 49
Unregistered

Total Unregistered 79
Less : Allowance for Doubtful Accounts 80

Total 89

P&C-1 (2011)
(Next page is 50.40)
50.40

Insurer Year
CONSOLIDATED
INTERESTS IN AND AMOUNTS RECEIVABLE FROM/PAYABLE TO SUBSIDIARIES, ASSOCIATES & JOINT VENTURES

Loans not
Interests/Loans considered as capital considered Receivable
as capital
% of Balance Increased Balance
Name of Entity Number of % Voting Aquisition Market Value Sheet (Decreased) in Sheet In Arrears Total Payable
and Description of Shares Shares Owned Rights Cost Value Balance Sheet Value
Value
(01) (02) (03) (04) (05) (06) (07) (08) (14) (09) (10) (11)

Subsidiaries consolidated in MCT

Total Subsidiaries consolidated in MCT 49


Other

Total Other 79

Total 89

P&C-1 (2012)
(Next page is 50.50)
50.50

Insurer Year

CONSOLIDATED

OTHER ASSETS, PROVISIONS AND OTHER LIABILITIES, and


UNRECOGNIZED ASSETS and LIABILITIES
($'000)

Other assets
(02)

Computer Software 30
Miscellaneous 38

Total other assets 39

Provisions and Other liabilities


(02)

Self-Insured Retention (SIR) portion of unpaid claims 50


Subordinated Indebtedness 60
Preferred Shares - Debt
- Redeemable within 5 years 70
- Other 71
Employment Benefits 76
Miscellaneous 88

Total provisions and other liabilities 89

Unrecognized assets excluding amounts reported


on Page 70.40 91

Unrecognized liabilities excluding amounts reported


on Page 70.40 95

P&C-1 (2012)
(Next page is 60.10)
60.10

Insurer Year
CONSOLIDATED

UNEARNED PREMIUMS
($'000)

Unearned Premiums
Direct Reinsurance Reinsurance Net
assumed ceded (01 + 02 - 03)
Class of Insurance
(01) (02) (03) (04)
Property - Personal excluding Home and Product Warra 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

Out of Canada Liabilities 80

P&C-1 (2012)
(Next page is 60.20)
60.20

Insurer Year
CONSOLIDATED
PREMIUMS AND CLAIMS
($'000)
Number of Number Premiums written less return premiums Net unearned Net unearned Net unearned Net premiums Claims incurred including adjustment expenses Claims ratio
Policies of Direct Direct Reinsurance Reinsurance Net written premiums at premiums premiums at earned Direct Reinsurance Reinsurance Net incurred (11/07)
Class of Insurance in force Claims assumed ceded (01+02-03) beginning of resulting from period end (04+05+25-06) assumed ceded (08+09-10) %
year a portfolio
acquisition/
disposition
(21) (23) (01) (02) (03) (04) (05) (25) (06) (07) (08) (09) (10) (11) (12)
Property - Personal excluding Home and Product Warra 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

P&C-1 (2012)
(Next page is 60.21)
60.21

Insurer Year
CONSOLIDATED
CLAIMS INCURRED - UNDISCOUNTED
($'000)
Claims incurred undiscounted
Reinsurance Reinsurance Net incurred
Class of Insurance Direct assumed ceded (08+09-10)
(08) (09) (10) (11)
Property - Personal excluding Home and Product Warra 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

DISCOUNTED AMOUNTS AND FOREIGN EXCHANGE


($'000)
Current Prior
Year Year
Performance Analysis (01) (03)
Underwriting Income (Loss) 90
Impact of Change in Claims Net Discount Rate 91
Impact of Unrealized Foreign Exchange Gains/Losses 92
Underwriting Income (Loss) Before Changes 93

GAINS & LOSSES ON INVESTMENTS


($'000)
Current Prior
Year Year
Gains and Losses on Investments (01) (03)
Realized Gains (Losses) on Held for Trading Financial Instruments 94
Realized Gains (Losses) on Other Financials Instruments 95
Unrealized Gains (Losses) on Held for Trading Financial Instruments 96
Total Gains and Losses on Investments 99
P&C-1 (2012)
(Next page is 60.30)
60.30

Insurer Year
CONSOLIDATED
CLAIMS AND ADJUSTMENT EXPENSES - PAID, CURRENT YEAR AND UNPAID, CURRENT AND PRIOR YEAR
($'000)
Claims and adjustment expenses paid - current year Provision for unpaid claims (including unreported) and Margin or deficiency for unpaid claims at prior year
adjustment expenses - current year
Net amount Investment Net provision
Net provision paid during income on for claims of Margin or
Reinsurance Reinsurance Net Reinsurance Reinsurance Net at prior the year unpaid claims prior years (Deficiency)
Class of Insurance Direct assumed ceded (01+02-03) Direct assumed ceded (05+06-07) year end for claims of of prior years (09-10+13-15)
prior years
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (13) (15) (19)
Property - Personal excluding Home and Product Warran 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

Out of Canada Liabilities 80


P&C-1 (2012)
(Next page is 60.40)
60.40

Insurer Year
CONSOLIDATED
NET CLAIMS AND ADJUSTMENT EXPENSES - RUN-OFF
($'000)

…….. …….. …….. …….. …….. ……..


and …….. and prior …….. and prior …….. and prior …….. and prior …….. and prior
prior years (02) + (03) (04) + (05) (06) + (07) (08) + (09) (10) + (11)
(02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12)
…….. * UCAE, end of year 01
IBNR, end of year 02
…….. Paid during year 10
UCAE, end of year 11
IBNR, end of year 12
Ratio: excess (deficiency) 19
…….. Paid during year 20
UCAE, end of year 21
IBNR, end of year 22
Ratio: excess (deficiency) 29
…….. Paid during year 30
UCAE, end of year 31
IBNR, end of year 32
Ratio: excess (deficiency) 39
…….. Paid during year 40
UCAE, end of year 41
IBNR, end of year 42
Ratio: excess (deficiency) 49
…….. Paid during year 50
UCAE, end of year 51
IBNR, end of year 52
Ratio: excess (deficiency) 59

* UCAE= Unpaid Claims and Adjustment Expenses (excluding IBNR). P&C-1 (2011)
(Next page is 60.41)
60.41

Insurer Year
CONSOLIDATED
NET CLAIMS AND ADJUSTMENT EXPENSES - RUN-OFF - DISCOUNTED
($'000)
…….. …….. …….. …….. …….. ……..
and …….. and prior …….. and prior …….. and prior …….. and prior …….. and prior
prior years (02) + (03) (04) + (05) (06) + (07) (08) + (09) (10) + (11)
(02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12)
…….. * UCAE, end of year 01
IBNR, end of year 02
…….. Paid during year 10
UCAE, end of year 11
IBNR, end of year 12
Investment Income from UCAE & IBNR 13
Ratio: excess (deficiency) 19
…….. Paid during year 20
UCAE, end of year 21
IBNR, end of year 22
Investment Income from UCAE & IBNR 23
Ratio: excess (deficiency) 29
…….. Paid during year 30
UCAE, end of year 31
IBNR, end of year 32
Investment Income from UCAE & IBNR 33
Ratio: excess (deficiency) 39
…….. Paid during year 40
UCAE, end of year 41
IBNR, end of year 42
Investment Income from UCAE & IBNR 43
Ratio: excess (deficiency) 49
…….. Paid during year 50
UCAE, end of year 51
IBNR, end of year 52
Investment Income from UCAE & IBNR 53
Amount: excess (deficiency) 54
Ratio: excess (deficiency) 59

* UCAE= Unpaid Claims and Adjustment Expenses (excluding IBNR). P&C-1 (2011)
(Next page is 60.50)
60.50

Insurer Year

CONSOLIDATED

DIRECT ADJUSTMENT EXPENSES


($'000)

(01)

Paid Adjustment Expenses


Internal adjustment expenses 01

External adjustment expenses


a. Adjusters and Appraisers 10
b. Legal 11
c. Other 12
Total (line 10+11+12) 19
Total Paid Adjustment Expenses (line 01+19) 39

Unpaid Adjustment Expenses


Provision for internal adjustment expenses - end of year 40
Provision for external adjustment expenses - end of year 41

Provision for internal adjustment expenses - beginning of year 42


Provision for external adjustment expenses - beginning of year 43
Total (line 40+41-42-43) 49

TOTAL ADJUSTMENT EXPENSES INCURRED (line 39+49) 59

Internal adjustment expenses incurred (line 01+40-42) 69

External adjustment expenses incurred (line 19+41-43) 79

P&C-1 (2012)
(Next page is 67.10)
67.10

Insurer Year
CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF PREMIUMS WRITTEN
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
LICENSED (Y / N) 01
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89
Dividends - direct 99
P&C-1 (2012)
(Next page is 67.20)
67.20

Insurer Year
CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF PREMIUMS EARNED
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89
P&C-1 (2012)
(Next page is 67.30)
67.30

Insurer Year
CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF CLAIMS INCURRED INCLUDING ADJUSTMENT EXPENSES
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89
P&C-1 (2012)
(Next page is 67.31)
67.31

Insurer Year
CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF CLAIMS INCURRED INCLUDING ADJUSTMENT EXPENSES - UNDISCOUNTED
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89
P&C-1 (2012)
(Next page is 70.10)
70.10

Insurer Year
CONSOLIDATED

PREMIUMS AND CLAIMS - REINSURANCE CEDED


($'000)

Premiums earned Claims incurred


Line of Business Quota Share Surplus Excess of Loss Facultative Total Quota Share Surplus Excess of Loss Facultative Total

(02) (03) (04) (05) (06) (07) (08) (09) (10) (11)

TOTAL 89

P&C-1 (2011)
(Next page is 70.21)
70.21

Insurer Year
CONSOLIDATED
SUMMARY OF REINSURANCE
($'000)

Reinsurance Ceded Reinsurance Assumed


Name of insurer Premiums Claims Unearned Outstanding Premiums Claims Unearned Outstanding
ceded to incurred by premiums losses assumed incurred premiums losses
assuming assuming ceded to recoverable from other by ceding assumed payable
insurer insurer assuming from assuming insurer insurer from other to ceding
insurer insurer insurer insurer
(02) (03) (04) (05) (06) (07) (08) (09)
Registered - Associated and Non-qualifying Subsidiary

Total Associated and Non-qualifying Subsidiary 49


Registered - Non-associated and Non-subsidiary

All others

Total Non-associated and Non-subsidiary 69

Total Registered Insurers 89

Total Unregistered Insurers 91

Total 99

P&C-1 (2012)
(Next page is 70.38)
70.38

Insurer Year
CONSOLIDATED

REINSURANCE CEDED TO UNREGISTERED INSURERS


($'000)

Premiums Claims Unearned Outstanding 10% margin Receivable Payable to Non-owned Letters of Recoverables Non-owned Margin
ceded incurred by premiums losses on unearned from assuming deposits held credit (LOCs) in excess of deposits and required
to assuming assuming ceded to recoverable premiums and assuming insurer as security held as Non-owned LOCs in (06-15/1.5)
Name of assuming insurer insurer insurer assuming from assuming outstanding insurer from assuming security Deposits excess of where
insurer insurer losses insurer from and LOCs recoverables positive
recoverable assuming (04+05+07 (12+16-(04+05
insurer -08-12-16) +07-08))
where positive where positive

(02) (03) (04) (05) (06) (07) (08) (12) (16) (14) (15) (17)
Associated and non-qualifying subsidiary

Total associated and non-qualifying subsidiary 49


Non-associated and Non-subsidiary

Total Non-associated and Non-subsidiary 69

TOTAL BUSINESS 89

Note: See Section VI of the P&C-1 instructions and the MCT Guideline. P&C-1 (2012)
(Next page is 70.40)
70.40

Insurer Year

CONSOLIDATED

REINSURANCE AND OTHER NON-OWNED ASSETS HELD ON DEPOSIT


and
LETTERS OF CREDIT
($'000)

Custodian Type of Expiry Date Amount


Name of Counterparty Investment
(01)
Non-owned Assets Held on Deposit $'000

Total Non-owned Assets Held on Deposit 09

Letters of Credit Held

Total Letters of Credit Held 29


Letters of Credit Provided to:

Total Letters of Credit Provided 89

P&C-1 (2011)
(Next page is 80.10)
80.10

Insurer Year
CONSOLIDATED

COMMISSIONS
($'000)

Commissions in respect of premiums written


Net Commissions
Deferred Unearned Direct Reinsurance Reinsurance Net Deferred Unearned attributable to
Commissions at Commissions at assumed ceded Commissions Commissions the period
Class of Insurance beginning beginning end of year end of year (02+07+09)-
of year of year (03+08)
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10)

Property - total 09
Automobile - total 29
Liability 59
Marine 68
Other 75
TOTAL 79
Summary of Commissions
Gross:
Commission Expense (line 79, column 02+04+05-08) 30
Contingent Commissions 33
Other Non-Deferrable Commissions 35
Total Gross (line 30+33+35) 39
Ceded:
Commission Income (line 79, column 03+06-09) 40
Contingent Commissions 43
Other Non-Deferrable Commissions 45
Total Ceded (line 40+43+45) 49
TOTAL NET COMMISSIONS (line 39-49) 89

P&C-1 (2011)
(Next page is 80.20)
80.20

Insurer Year

CONSOLIDATED

EXPENSES - INSURANCE OPERATIONS


($'000)

Acquisition Expenses
Expense Classification Deferred at End Attributable to General Internal
of Year the Year Expenses Adjustment
Expenses
(01) (02) (04) (06)
Salaries and employee benefits 50

Directors remuneration 52
Agency (excluding commissions) 54

Management fees 60
Professional fees 62

Occupancy 70

Information technology 72
Inspections and Investigations 74
Bureaus and Associations 76
Home Office overhead 78
Allowance 80

Regulatory assessments 82
Other expenses 88

Total 89

P&C-1 (2012)
(Next page is 90.15)
90.15

Insurer Year

CONSOLIDATED

OUT OF CANADA OPERATIONS

Page 90.15 is to be completed if the insurer is licensed in, or covers risks in any
foreign jurisdiction. Page 90.70 is to be completed only if business covering risks outside
of Canada constitutes more than 10% of either gross or net claims, incurred or unpaid,
or 10% of gross or net premiums written.

Date of Net Premiums Deposits Held


Foreign Jurisdiction Licensing Written by Regulatory
(if applicable) Authorities
($'000 - Cdn) ($'000 - Cdn)

P&C-1 (2011)
(Next page is 90.70)
90.70

Insurer Year
CONSOLIDATED
REINSURANCE CEDED - OUT OF CANADA BUSINESS
($'000 - Cdn)

Country of Claims and Unearned Receivable from Cash or other


incorporation Country of Premiums adjustment premiums and outstanding Payable to securities
Name of assuming insurer of assuming business* ceded to expense ceded to losses recoverable assuming held as security
insurer assuming insurer incurred by assuming insurer from assuming insurer from assuming
assuming insurer insurer insurer
(02) (03) (04) (05) (06) (07) (08) (09)

Associated & Non-Qualifying Subsidiary

Total associated and non-qualifying subsidia 49

Non-associated and Non-subsidiary

Total Non-associated and Non-subsidiary 69


TOTAL 89
*If insurer is registered or licensed in the jurisdiction of the business insert (R) beside the name of country. P&C-1 (2012)
(Next page is 92.10)
92.10

Insurer Year

NON CONSOLIDATED FINANCIAL STATEMENTS

ASSETS
($'000)

Current Prior
Year Year
(01) (03)

Cash and Cash Equivalents 01


Investment Income due and accrued 02
Assets held for sale 50

Investments:
Short Term Investments 04
Bonds and Debentures 05
Mortgage Loans 06
Preferred Shares 07
Common Shares 08
Investment Properties 09
Other Loans and Invested Assets 10

Total Investments (lines 04 to 10) 19

Receivables:
Unaffiliated Agents and Brokers 20
Policyholders 21
Instalment Premiums 22
Other Insurers 23
Facility Association and the "P.R.R." 24
Subsidiaries, Associates & Joint Ventures 25
Other Receivables 27

Recoverable from Reinsurers:


Unearned Premiums 30
Unpaid Claims and Adjustment Expenses 31
Other Recoverables on Unpaid Claims 37

Interests in Subsidiaries, Associates & Joint Ventures 40


Property and Equipment 41
Deferred Policy Acquisition Expenses 43
Current Tax Assets 52
Deferred Tax Assets 44
Goodwill 54
Intangible Assets 56
Other Assets 88
TOTAL ASSETS 89

P&C-1 (2012)
(Next page is 92.20)
92.20

Insurer Year

NON CONSOLIDATED FINANCIAL STATEMENTS

LIABILITIES AND EQUITY


($'000)

Current Prior
Year Year
(01) (03)

LIABILITIES
Overdrafts 01
Borrowed Money and Accrued Interest 02
Payables:
Agents and Brokers 03
Policyholders 04
Other Insurers 05
Subsidiaries, Associates & Joint Ventures 06
Expenses due and accrued 07
Other Taxes due and accrued 09
Policyholder Dividends and Rating Adjustments 10
Encumbrances on Real Estate 11
Unearned Premiums 12
Unpaid Claims and Adjustment Expenses 13
Unearned Commissions 14
Premium Deficiency 15
Liabilities held for sale 17
Current Tax Liabilities 18
Deferred Tax Liabilities 21
Provisions and Other Liabilities 28

Total Liabilities 29

EQUITY
Shares issued and paid 41
Contributed Surplus 42
(Specify) 43
Retained Earnings 44
Reserves 45
Accumulated Other Comprehensive Income (Loss) 47
Total Equity 49
TOTAL LIABILITIES AND EQUITY 89

P&C-1 (2012)
(Next page is 92.30)
92.30

Insurer Year
NON CONSOLIDATED FINANCIAL STATEMENTS

STATEMENT OF INCOME
($'000)
Current Prior
Year Year
(01) (03)
UNDERWRITING OPERATIONS
Premiums Written
Direct 01
Reinsurance Assumed 02
Reinsurance Ceded 03
Net Premiums Written 04
Decrease (increase) in Net Unearned Premiums 05
Net Premiums Earned 06
Service Charges 07
Other 08
Total Underwriting Revenue 09
Gross Claims and Adjustment Expenses 62
Reinsurers' share of claims and adjustment expenses 64
Net Claims and Adjustment Expenses 10
Acquisition Expenses
Gross Commissions 66
Ceded Commissions 68
Taxes 12
Other 14
General Expenses 16
Total Claims and Expenses 19
Premium Deficiency Adjustments 20
Underwriting Income (Loss) 29

INVESTMENT OPERATIONS
Income 32
Realized Gains (Losses) 33
Expenses 34
Net Investment Income 39
OTHER REVENUE AND EXPENSES
Income (Loss) from Ancillary Operations
(net of Expenses of $'000 ...................) 40
Share of Net Income (Loss) of Subsidiaries, Associates & Joint Ventures 41
Gains (Losses) from fluctuations in Foreign Exchange Rates 42
Other Revenues 44
Finance costs 45
Other Expenses 46
Net Income (Loss) before Income Taxes 49
INCOME TAXES
Current 50
Deferred 51
Total Income Taxes 59
NET INCOME (LOSS) FOR THE YEAR 89

P&C-1 (2012)
(Next page is 92.40)
92.40

Insurer Year

NON CONSOLIDATED FINANCIAL STATEMENTS

STATEMENT OF RETAINED EARNINGS


($'000)

Current Prior
Year Year
(01) (02)

Balance at beginning of year 01


Prior period adjustments: 02
(Specify) 04
Adjusted balance at beginning of year 09
Net income (loss) for the year 10
Dividends declared to shareholders 11
Decrease (increase) in Reserves 12
(Specify) 16
Net increase (decrease) in Retained Earnings
during the year 15

Balance at end of year 89

RESERVES
($000)

Current Prior
Year Year
(01) (02)
Earthquake Reserves
Reserve Complement 90
Premium Reserve 91
Mortgage Reserve 95
Nuclear Reserve 96
General and Contingency Reserves 98
Total Reserves 99

P&C-1 (2011)
(Next page is 92.42)
92.42

Insurer Year
NON CONSOLIDATED FINANCIAL STATEMENTS
COMPREHENSIVE INCOME (LOSS)
and
ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS)
($'000)

Current Prior
Year Year
(01) (03)

Comprehensive Income (Loss)


Net Income 01
Other Comprehensive Income (Loss):
Available for Sale:
Change in Unrealized Gains and Losses:
- Loans 02
- Bonds and Debentures 03
- Equities 04
Reclassification to Earnings of (Gains) Losses 05
Derivatives Designated as Cash Flow Hedges
Change in Unrealized Gains and Losses 06
Reclassification to Earnings of (Gains) Losses 07
Foreign Currency Translation
Change in Unrealized Gains and Losses 08
Impact of Hedging 09
Revaluation Surplus 31
Share of Other Comprehensive Income of Subsidiaries,
Associates & Joint Ventures 11
Other 12
Total Other Comprehensive Income (Loss) 21
Total Comprehensive Income (Loss) 39

Current Prior
Year Year
(01) (03)
Accumulated Other Comprehensive Income (Loss)
Accumulated Gains (Losses) on:
Available for Sale:
- Loans 42
- Bonds and Debentures 43
- Equities 44
Derivatives Designated as Cash Flow Hedges 45
Foreign Currency (net of hedging activities) 46
Revaluation Surplus 71
Share of Other Comprehensive Income of Subsidiaries,
Associates & Joint Ventures 51
Other 49
Balance at end of Year 59

P&C-1 (2012)
(Next page is 93.10)
93.10

Insurer Year
NON CONSOLIDATED
PREMIUMS AND CLAIMS
($'000)
Number of Number Premiums written less return premiums Net unearned Net unearned Net unearned Net premiums Claims incurred including adjustment expenses Claims ratio
Policies of Direct Direct Reinsurance Reinsurance Net written premiums at premiums premiums at earned Direct Reinsurance Reinsurance Net incurred (11/07)
Class of Insurance in force Claims assumed ceded (01+02-03) beginning of resulting from period end (04+05+25-06) assumed ceded (08+09-10) %
year a portfolio
acquisition/
disposition
(21) (23) (01) (02) (03) (04) (05) (25) (06) (07) (08) (09) (10) (11) (12)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

P&C-1 (2012)
(Next page is 93.11)
93.11

Insurer Year
NON CONSOLIDATED
CLAIMS INCURRED - UNDISCOUNTED
($'000)
Claims incurred undiscounted
Reinsurance Reinsurance Net incurred
Class of Insurance Direct assumed ceded (08+09-10)
(08) (09) (10) (11)
Property - Personal excluding Home and Product Warran 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

DISCOUNTED AMOUNTS AND FOREIGN EXCHANGE


($'000)
Current Prior
Year Year
Performance Analysis (01) (03)
Underwriting Income (Loss) 90
Impact of Change in Claims Net Discount Rate 91
Impact of Unrealized Foreign Exchange Gains/Losses 92
Underwriting Income (Loss) Before Changes 93

GAINS & LOSSES ON INVESTMENTS


($'000)
Current Prior
Year Year
Gains and Losses on Investments (01) (03)
Realized Gains (Losses) on Held for Trading Financial Instruments 94
Realized Gains (Losses) on Other Financials Instruments 95
Unrealized Gains (Losses) on Held for Trading Financial Instruments 96
Total Gains and Losses on Investments 99
P&C-1 (2012)
(Next page is 93.20)
93.20

Insurer Year
NON CONSOLIDATED
CLAIMS AND ADJUSTMENT EXPENSES - PAID, CURRENT YEAR AND UNPAID, CURRENT AND PRIOR YEAR
($'000)
Claims and adjustment expenses paid - current year Provision for unpaid claims (including unreported) and Margin or deficiency for unpaid claims at prior year
adjustment expenses - current year
Net amount Investment Net provision
Net provision paid during income on period end Margin or
Reinsurance Reinsurance Net Reinsurance Reinsurance Net at prior the year unpaid claims for claims of (Deficiency)
Class of Insurance Direct assumed ceded (01+02-03) Direct assumed ceded (05+06-07) year end for claims of of prior years prior years (09-10+13-15)
prior years
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (13) (15) (19)
Property - Personal excluding Home and Product Warran 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
TOTAL 89

Out of Canada Liabilities 80


P&C-1 (2012)
(Next page is 93.30)
93.30

Insurer Year
NON CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF PREMIUMS WRITTEN
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
LICENSED (Y / N) 01
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89
Dividends - direct 99

P&C-1 (2012)
(Next page is 93.35)
93.35

Insurer Year
NON CONSOLIDATED
INSURERS LICENSED IN QUEBEC
PROVINCIAL AND TERRITORIAL EXHIBIT OF PREMIUMS WRITTEN (Policies with a term of more than 12 months)
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89
Dividends - direct 99

P&C-1 (2012)
(Next page is 93.40)
93.40

Insurer Year
NON CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF PREMIUMS EARNED
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89

P&C-1 (2012)
(Next page is 93.50)
93.50

Insurer Year
NON CONSOLIDATED
PROVINCIAL AND TERRITORIAL EXHIBIT OF CLAIMS INCURRED INCLUDING ADJUSTMENT EXPENSES
($'000)
Prince New British Northwest Out of Total
Newfoundland Edward Nova Scotia Brunswick Quebec Ontario Manitoba Saskatchewan Alberta Columbia Yukon Territories Nunavut Canada
Class of Insurance & Labrador Island
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12) (14) (18) (19)
Property - Personal excluding Home and Product Warranty 03
- Home Warranty 04
- Product Warranty 05
- Commercial 07
Property - total 09
Aircraft 10
Automobile:
Private Passenger - Liability 11
- Personal Accident 12
- Other 13
Subtotal - Private Passenger 14
Other than Private Passenger - Liability 15
- Personal Accident 16
- Other 17
Subtotal - Other than Private Passenger 18
Facility Assoc. Residual Market - Liability 22
- Personal Accident 23
- Other 24
Subtotal - Facility Assoc. Residual Market 25
Automobile - Subtotal - Liability 19
- Personal Accident 20
- Other 21
Automobile - total 29
Boiler and Machinery excluding Equipment Warranty 32
- Equipment Warranty 33
Credit 34
Credit Protection 35
Fidelity 36
Hail 38
Legal Expense 40
Liability 59
Mortgage 62
Other Approved Products 63
Surety 64
Title 66
Marine 68
Accident and Sickness 70
Total - direct 79
Reinsurance assumed 87
Reinsurance ceded 88
TOTAL - NET 89

P&C-1 (2012)
(Next page is 93.60)
93.60

Insurer Year
NON CONSOLIDATED
NET CLAIMS AND ADJUSTMENT EXPENSES - RUN-OFF
($'000)

…….. …….. …….. …….. …….. ……..


and …….. and prior …….. and prior …….. and prior …….. and prior …….. and prior
prior years (02) + (03) (04) + (05) (06) + (07) (08) + (09) (10) + (11)
(02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12)
…….. * UCAE, end of year 01
IBNR, end of year 02
…….. Paid during year 10
UCAE, end of year 11
IBNR, end of year 12
Ratio: excess (deficiency) 19
…….. Paid during year 20
UCAE, end of year 21
IBNR, end of year 22
Ratio: excess (deficiency) 29
…….. Paid during year 30
UCAE, end of year 31
IBNR, end of year 32
Ratio: excess (deficiency) 39
…….. Paid during year 40
UCAE, end of year 41
IBNR, end of year 42
Ratio: excess (deficiency) 49
…….. Paid during year 50
UCAE, end of year 51
IBNR, end of year 52
Ratio: excess (deficiency) 59

* UCAE= Unpaid Claims and Adjustment Expenses (excluding IBNR). P&C-1 (2011)
(Next page is 93.61)
93.61

Insurer Year
NON CONSOLIDATED
NET CLAIMS AND ADJUSTMENT EXPENSES - RUN-OFF - DISCOUNTED
($'000)
…….. …….. …….. …….. …….. ……..
and …….. and prior …….. and prior …….. and prior …….. and prior …….. and prior
prior years (02) + (03) (04) + (05) (06) + (07) (08) + (09) (10) + (11)
(02) (03) (04) (05) (06) (07) (08) (09) (10) (11) (12)
…….. * UCAE, end of year 01
IBNR, end of year 02
…….. Paid during year 10
UCAE, end of year 11
IBNR, end of year 12
Investment Income from UCAE & IBNR 13
Ratio: excess (deficiency) 19
…….. Paid during year 20
UCAE, end of year 21
IBNR, end of year 22
Investment Income from UCAE & IBNR 23
Ratio: excess (deficiency) 29
…….. Paid during year 30
UCAE, end of year 31
IBNR, end of year 32
Investment Income from UCAE & IBNR 33
Ratio: excess (deficiency) 39
…….. Paid during year 40
UCAE, end of year 41
IBNR, end of year 42
Investment Income from UCAE & IBNR 43
Ratio: excess (deficiency) 49
…….. Paid during year 50
UCAE, end of year 51
IBNR, end of year 52
Investment Income from UCAE & IBNR 53
Amount: excess (deficiency) 54
Ratio: excess (deficiency) 59

* UCAE= Unpaid Claims and Adjustment Expenses (excluding IBNR). P&C-1 (2011)
(Next page is 95.10)
95.10

Insurer Year
NON CONSOLIDATED
INSURERS LICENSED IN QUEBEC
PREMIUMS AND CLAIMS - REINSURANCE CEDED
($'000)

Premiums earned Claims incurred


Line of Business Quota Share Surplus Excess of Loss Facultative Total Quota Share Surplus Excess of Loss Facultative Total

(02) (03) (04) (05) (06) (07) (08) (09) (10) (11)

TOTAL 89

P&C-1 (2011)
(Next page is 95.20)
95.20

Insurer Year
NON CONSOLIDATED
INSURERS LICENSED IN QUEBEC
COMMISSIONS
($'000)

Commissions in respect of premiums written


Net Commissions
Deferred Unearned Direct Reinsurance Reinsurance Net Deferred Unearned attributable to
Commissions at Commissions at assumed ceded Commissions Commissions the period
Class of Insurance beginning beginning end of year end of year (02+07+09)-
of year of year (03+08)
(01) (02) (03) (04) (05) (06) (07) (08) (09) (10)

Property - total 09
Automobile - total 29
Liability 59
Marine 68
Other 75
TOTAL 79
Summary of Commissions
Gross:
Commission Expense (line 79, column 02+04+05-08) 30
Contingent Commissions 33
Other Non-Deferrable Commissions 35
Total Gross (line 30+33+35) 39
Ceded:
Commission Income (line 79, column 03+06-09) 40
Contingent Commissions 43
Other Non-Deferrable Commissions 45
Total Ceded (line 40+43+45) 49
TOTAL NET COMMISSIONS (line 39-49) 89

P&C-1 (2011)
(Next page is 99.10)
99.10

Insurer Year

AFFIDAVIT VERIFYING ANNUAL RETURN

WE, OF THE
(Print or type)

OF IN THE PROVINCE OF

AND OF THE

OF IN THE PROVINCE OF

BEING AND

RESPECTIVELY OF

(HEREINAFTER CALLED "THE INSURER") DO SEVERALLY MAKE OATH AND SAY AS FOLLOWS:

That the foregoing annual return, together with the related exhibits, schedules
and explanations filed or to be filed as part thereof, is a full and correct report of
all assets, liabilities, income, expenditure and of the condition and affairs of the
insurer in respect of its business of insurance, as of the
31st day of ..................................... 20 ......., and for the year ended on that day;

That all the assets reported in the said annual return and schedules were, as of the
31st day of ..................................... 20 ......., the absolute property of the insurer free
and clear from any liens and claims except as therein stated;

That we have satisfied ourselves, based on the information currently available, that
the provision for unpaid claims and adjustment expenses, as shown in the annual
return is adequate to cover all costs of ultimate settlement, including internal and
external adjustment expenses and claims that have been incurred but not reported;

That the insurer is in compliance with the applicable Federal, Provincial and
Territorial Insurance Acts and Regulations.

(Signature)

(Signature)

SEVERALLY SWORN TO BEFORE ME IN THE

OF IN THE PROVINCE

OF THIS

DAY OF 20

(STATE WHETHER COMMISSIONER, NOTARY PUBLIC, ETC.)

P&C-1 (2003)
End

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